1235127283 NPI number — DR. ROSARIO G. LASERNA M.D.

Table of content: DR. ROSARIO G. LASERNA M.D. (NPI 1235127283)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235127283 NPI number — DR. ROSARIO G. LASERNA M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LASERNA
Provider First Name:
ROSARIO
Provider Middle Name:
G.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1235127283
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4103 LAFAYETTE BLVD
Provider Second Line Business Mailing Address:
OB-GYN ASSOCIATES OF FREDERICKSBURG, PC
Provider Business Mailing Address City Name:
FREDERICKSBURG
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22580
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-898-0295
Provider Business Mailing Address Fax Number:
540-891-0225

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4103 LAFAYETTE BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FREDERICKSBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22580
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-898-0295
Provider Business Practice Location Address Fax Number:
540-891-0225
Provider Enumeration Date:
10/12/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  0101026125 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 07-00534 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 10947 . This is a "HARRINGTON BENEFITS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: C42000002 . This is a "CAPITAL CARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 212496 . This is a "MAMSI/OPTIMUM CHOICE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 6264930 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1256767001 . This is a "CIGNA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 481136 . This is a "AETNA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 6264930 . This is a "VIRGINIA PREMIER" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 10947 . This is a "SENTARA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 20436 . This is a "CARENET" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 002557 . This is a "ANTHEM BLUE CROSS BLUE SH" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 541051109-02 . This is a "SOUTHERN HEALTH" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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